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Cardio > Rhythm disorders > Flashcards

Rhythm disorders Flashcards

1
Q

Checks to perform on an ECG

A
  1. Correct recording? (px name/age/EMIS)
  2. Review the signal quality and leads
  3. Verify the voltage and paper speed
  4. Review the patient background
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2
Q

What is the step by step process of interpreting an ECG?

A

Rate and Rhythm
P-wave and P-R interval
QRS duration
QRS axis (cardiac axis)
ST segment
QT interval/T wave

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3
Q

What are the features of a sinus rhythm ECG?

A

Each P wave is followed by a QRS complex (1:1) // Regular rate and normal bpm

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4
Q

What are the features of a sinus bradycardia ECG?

A

Each P wave is followed by a QRS complex (1:1)
Regular rate but SLOW bpm (<65)

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5
Q

What are the features of a sinus tachycardia ECG?

A

Each P wave is followed by a QRS complex (1:1)
Regular rate but FAST bpm (>100)

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6
Q

What are the features of a sinus arrhythmia ECG?

A

Each P wave is followed by a QRS complex (1:1)
Irregular rate (variable R-R intervals)
Normal range of bpm (65-100)

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7
Q

What does sinus mean?

A

Rhythm generated by the SAN

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8
Q

What can cause sinus bradycardia

A

Medication
Normal - red. HR for athletes due to muscular heart
Vagal stimulation

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9
Q

What can cause sinus tachycardia

A

physiological response to stimulus

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10
Q

When can rate be faster and slower in sinus arrhythmia?

A

Slower - long expiration
Faster - long inspiration

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11
Q

How to calculate Heart rate

A

300/no. large squares

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12
Q

What is happening in atrial fibrillation?

A

Abnormal irregular contraction of atria

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13
Q

What are the features of an atrial fibrillation ECG?

A

Oscillating baseline (atria contracts asynchronously), Irregular Rhythm,
Slow Rate

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14
Q

What is a complication of atrial fibrillation?

A

Clotting - due to turbulent flow

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15
Q

What is happening in atrial flutter?

A

Abnormally fast REGULAR contraction of atria

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16
Q

What are the features of an atrial flutter ECG?

A

Saw-tooth pattern in baseline (not present in everyone)
Multiple P waves followed by QRS complex (2:1 or 3:1)

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17
Q

What is happening in first degree heart block?

A

Delay in Atrioventricular Node in conducting QRS complex, typically with aging

18
Q

What are the features of a first degree heart block ECG?

A

Prolonged PR segment/interval
Regular rhythm

19
Q

What causes first degree heart block

A

Ageing

20
Q

What are the two types of second degree heart block?

A

Mobitz Type I and Mobitz Type II

21
Q

What is happening in second degree heart block?

A

Delay in Atrioventricular Node in conducting QRS complex, sometimes current does not reach the ventricles

22
Q

What are the features of a Mobitz Type I Second Degree Heart Block ECG?

A

Gradual prolongation of PR segment/interval until there is a missing QRS.
Regularly irregular - (beat, beat, no beat) looped.

23
Q

What is the cause of Mobitz 1 2º HB

A

diseased AVN

24
Q

What are the features of a Mobitz Type II Second Degree Heart Block ECG?

A

No PR prolongation,
Regular P waves
Some missing QRS
Regular irregular (can follow 2:1 pattern or be completely random)

25
Q

What can mobitz II 2º HB deteriorate into

A

3º HB

26
Q

What are the features of a third degree heart block ECG?

A

P-P intervals are regular
R-R intervals are regular
But P and R intervals are completely irregular - non-sinus rhythm

27
Q

What is happening in third degree heart block?

A

Complete block of AVN
However ventricular contraction still occurs (self stimulating), disjointed w/ atrial contrac

28
Q

What is happening in ventricular tachycardia?

A

Ventricles are contracting too fast, disjointed atrial contraction, but regularly

29
Q

What are the features of a ventricular tachycardia ECG?

A

Hidden P waves,
Regular and Fast Rate (100-200)

30
Q

V.Tach risks

A

Cardiac arrest with deterioration in fibrillation
.: use defibrillator (shockable rhythm)

31
Q

What is happening in ventricular fibrillation?

A

Cardiac Arrest - irregular extremely fast ventricular contractions (uncoordinated e- activity)

32
Q

What are the features of a ventricular fibrillation ECG?

A

Irregular heart rate over 250bpm

33
Q

How can you treat ventricular arrythmias?

A

Defibrillator - they are shockable rhythms

34
Q

What is an example of a non-shockable rhythm?

A

Flat-lining - asystole
(adrenaline injections)

35
Q

What causes movement of the ST segment

A

Perfusion defect

36
Q

What is happening in ST-Elevation?

A

Perfusion defect caused by infarction
(tissue death due to hypoperfusion)

37
Q

What are the features of an ST-Elevation ECG?

A

1:1 P waves and QRS complexes
Regular rate and normal BPM
ST segment is elevated by more than 2mm (2 tiny boxes) above isoelectric line

38
Q

What is happening in ST-Depression?

A

Perfusion defec due to myocardial ischaemia
(coronary insufficiency/hypoxia)

39
Q

What are the features of an ST-Depression ECG?

A

1:1 P waves and QRS complexes
Regular rate and normal BPM
ST segment is depressed more than 2mm (2 tiny boxes) below isoelectric line

40
Q

Infarction vs Ischaemia

A

Infarction: Blood flow completely cut off -> necrosis
Ischaemia: Red. blood flow -> hypoxia

Cardio (10 decks)

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